Provider Demographics
NPI:1053786079
Name:NEAL M. KUBO O.D. INC.
Entity type:Organization
Organization Name:NEAL M. KUBO O.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:KUBO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:808-677-2333
Mailing Address - Street 1:PO BOX 29690
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96820-2090
Mailing Address - Country:US
Mailing Address - Phone:808-677-2333
Mailing Address - Fax:808-677-2313
Practice Address - Street 1:94-300 FARRINGTON HWY
Practice Address - Street 2:SUITE E2
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-2648
Practice Address - Country:US
Practice Address - Phone:808-677-2333
Practice Address - Fax:808-677-2313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD-391152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIOD-391OtherMEDICAL LICENSE